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Suicide: A concern for all health care providers

Part 3 ? After screening/assessing: How to assure safety of the person who is at risk for suicide

When it is determined that a patient is at risk for suicide, there could be many responses by the provider. One response that is becoming the standard for both behavioral health providers (BHP) and primary care physicians (PCP) is the Suicide Care Management Plan.¹ The plan is developed in collaboration with the patient during an open discussion with the goal of preventing the patient from acting on his or her suicidal impulses. This response uses the healthy connectedness of the relationship between the provider and patient to promote coordination and collaboration that will assure safety for the patient. However, some patients are reluctant to tell providers that they may have suicidal ideas. For some, they are embarrassed, and for others, they may fear being hospitalized. In such cases, it is the responsibility of the provider to develop the trusting relationship that encourages all patients to talk openly about their concerns.²

For the PCP, an important aspect of the plan is to ensure that the patient is seen that same day by a BHP. If a BHP is not immediately available, contact Magellan Healthcare, Inc. by calling the phone number on the back of the member's ID card and choosing the "Crisis" option to find providers. Another option is to refer the patient to a Crisis Center for a behavioral health evaluation. A list of local crisis centers will be available on our website and the NaviNet^® web portal in the next few months.

For both the PCP and BHP, the Suicide Care Management Plan should also include the self-management techniques the patient will use to maintain his or her safety, which includes preventing access to means for suicide and how the patient will involve his or her support systems to enhance efforts to stay safe. Another important aspect of the plan includes follow-up with the patient to evaluate his or her status and make modifications, if necessary.³

Most importantly, all health care providers should do the following for a patient who is at risk for suicide:

• Discuss their concerns and Suicide Care Management Plan directly with the patient.
• Make sure the plan is brief and clear and that the patient has a copy.
• Encourage involvement of support systems.
• Always act for the safety of the patient.³

¹www.zerosuicide.com

²Jobes, D, et al. Ethical and competent care of suicidal patients: Contemporary challenges, new developments, and considerations for clinical practice (2008). Professional Psychology: Research and Practice, Vol 39(4), Aug 2008, 405-413.

³Stanley, B., & Brown, G. (2012). Safety Planning Intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256?264. See more at http://zerosuicide.sprc.org/resources/safety-planning-intervention-brief-interve ntion-mitigatesuicide- risk#sthash.I6pNi6k5.dpuf.

Magellan Healthcare, Inc., an independent company, manages mental health and substance abuse benefits for most Independence members.

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